This blog was inspired by ACH CEO Amanda Pears Kelly’s LinkedIn article, “When the Foundation Shifts: Community Health Centers Contend with a Forced Game of Jenga.”
Primary Care: A Foundation Under Pressure
For more than 60 years, community health centers (CHCs) have delivered high-quality care to nearly 34 million Americans, regardless of income, geography, or insurance status.
But as ACH CEO Amanda Pears Kelly writes in her recent LinkedIn article, it’s starting to feel like “a forced game of Jenga” — each new policy proposal, funding delay, or regulatory shift removes another block from a once-solid foundation.
That tower represents the structure of community-based primary care. And right now, it’s wobbling.
The Stacking Challenges Facing CHCs
In the piece, Pears Kelly highlights the growing list of pressures that threaten CHCs’ stability:
- Uncertain federal funding, which forces centers to plan month-to-month instead of strategically year-to-year.
- Erosion of the 340B Drug Pricing Program, a critical mechanism allowing CHCs to reinvest savings directly into patient care.
- Severe workforce shortages in rural and underserved areas, stretching already limited staff.
- Medicaid cuts, threatening coverage for millions.
- Federal government shutdowns, disrupting funding and operations nationwide.
Each pressure alone poses a serious risk. Together, they form what Pears Kelly calls “policy Jenga,” a precarious balancing act where every move weakens the system.
What’s at Stake for Community Health
When a CHC delays hiring, when 340B savings disappear, or when a local maternal health program shuts down quietly, it may not make national news, but the impact is real.
These micro-cracks in primary care accumulate. Eventually, the remaining structure can’t bear the weight. And when that happens, the loss is measured not in budgets or block towers, but in lives and access.
Pears Kelly’s message is a warning and a clear call for action:
Community health centers “are not a temporary fix or a safety valve; they are the core of care in communities across America, and a solution for our healthcare system.”
To stabilize the system, ACH urges policymakers and partners to:
- Ensure long-term, predictable federal funding for CHCs.
- Protect and strengthen the 340B Drug Pricing Program.
- Invest in workforce development pipelines like the Teaching Health Centers Graduate Medical Education program.
- Recognize CHCs as essential infrastructure, not backup plans.
As Pears Kelly reminds us, we don’t need to wait for collapse. Let’s strengthen and reinforce what works now.
Read the full article and share your perspective on LinkedIn:
When the Foundation Shifts: Community Health Centers Contend with a Forced Game of Jenga | LinkedIn